Healthcare Provider Details

I. General information

NPI: 1851377386
Provider Name (Legal Business Name): LISA ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 176 ESQ AVE SAN CLAUDIO SAN GENARO 352
SAN JUAN PR
00926
US

IV. Provider business mailing address

RR 6 BOX 9318
SAN JUAN PR
00926-9402
US

V. Phone/Fax

Practice location:
  • Phone: 787-760-1280
  • Fax: 787-283-3673
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2595
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: